Operations Associate - Claims Associate

Description

Company Description:

Aspida is a tech-driven, nimble insurance carrier. Backed by Ares Management Corporation, a leading global alternative asset manager, we offer simple and secure retirement solutions and annuity products with speed and precision. More than that, we’re in the business of protecting dreams; those of our partners, our producers, and especially our clients. Our suite of products, available through our elegant and intuitive digital platform, focuses on secure, stable retirement solutions with attractive features and downside protection.

A subsidiary of Ares Management Corporation (NYSE: ARES) acts as the dedicated investment manager, capital solutions and corporate development partner to Aspida. For more information, please visit  or follow them on Linked In.

Who We Are:

Sometimes, a group of people come together and create something amazing. They don’t let egos get in the way. They don’t settle for the status quo, and they don’t complain when things get tough. Instead, they see a common vision for the future and each person makes an unspoken commitment to building that future together. That’s the culture, the moxie, and the story of Aspida.

Our business focuses on annuities and life insurance. At first, it might not sound flashy, but that’s why we’re doing things differently than everyone else in our industry. We’re dedicated to developing data-driven tech solutions, providing amazing customer experiences, and applying an entrepreneurial spirit to everything we do. Our work ethic is built on three main tenets:
Get $#!+ Done, Do It with Moxie, and Have Fun. If this sounds like the place for you, read on, and then apply at

What We Are Looking For:

The Claims Specialist will be responsible for the evaluation, investigation, and resolution of life and annuity claims, perform diverse duties relating to the intake, processing, review, and adjudication of claims, including reviewing for accuracy, file and claim completeness, reviewing coverage and approving payment or denial. The ideal candidate must be empathetic while assisting individuals that are facing difficult life experiences. The right person for this role has strong organization skills and capacity to recall complex business rules in addition to varied state regulations as they pertain to claims settlements and tax implications.

Individuals must have strong communication skills and ability to work with and adjust to all other personality types. This is a fast-paced team that requires dedicated and prompt team members to ensure nothing sits idle without attention for any span of time. Successful analysts will handle a multitude of activities moving from one task to the next in a fast, efficient, and accurate manner.

This role reports to the Operations Manager and is required to be onsite 3 days a week at our Durham, NC headquarters.

What You Will Do:

· Evaluate and determine claim coverage for benefits in accordance with policy and/or certificate provisions, and department procedures.

· Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.

· Establish claim reserves and authorize payments within authority limits.

· Enter claim payments, reserves, and new claims on various computer programs, inputting concise yet sufficient file documentation.

· Contact and/or interview claimants, doctors, medical specialists, or employers to obtain additional information as needed.

· Manage time adequately to ensure proper turn around for all tasks such as new claims, pending claims, customer service requests, and audit feedback.

· Maintain quality and production standards as defined by procedures and management.

· Communicate with legal counsel on claims requiring litigation.

· Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.

· Report over payments, underpayments, and other irregularities.

· Ability to look at processes and offer suggestions for efficiencies.

· Work with teammates and supervisor to ensure the needs of the claimants are being met.

· Comply with HIPAA, Diversity…